巨大儿发生的相关因素及生长发育情况分析

The risk factors and the characteristic patterns of development changes of macrosomia

目的探讨巨大儿发生的相关危险因素及生长发育特点。方法回顾性分析208例巨大儿的临床资料，通过Logistic回归分析方法筛选与巨大儿发生相关的危险因素；选择同期出生的体质量正常的208例新生儿为对照组，并随访记录两组婴幼儿3、6、9、12、18、24、30、36个月等各监测点的两组体质量、身长，采用CDCC测试并计算两组婴幼儿智力发育指数（MDI）及运动发育指数（PDI），通过统计学分析进行比较。结果Logistic~归分析显示孕妇年龄、孕前身高、孕前体质量、孕期增重、营养状况、活动情况、家族肥胖及父亲体质量是巨大儿发生的危险因素。巨大儿组体质量和身长在30个月以内均大于对照组（均P〈0．05），但到36个月时，巨大儿组与对照组之间身长差异无统计学意义（P〉0．05）。巨大儿组MDI、PDI值分别为（107．33±7．29）、（104．71±6．93），与对照组的（112．58±7．61）、（109．09±7．14）比较，差异均有统计学意义（t=4．28、5．33，均P〈0．01）。结论巨大儿发生与遗传、环境等多种因素相关；在婴幼儿期巨大儿的体质量大于正常出生体质量儿；巨大儿智力和运动发育均落后于正常出生体质量儿。

Objective To investigate the risk factors and the characteristic patterns of development changes of maerosomia. Methods 208 eases of maerosomia were collected. Then the risk factors related to maerosomia by use of Logistic regression analysis were researched. 208 infants of normal birth weight were selected as control group. The weight and length in 8 growth development monitoring time according to their health care manual were recorded. Mental development index（MDI） and physical development index （PDI） were tested and calculated by CDCC method when macrosomia and normal birth weight infants were 30 months. The characteristic patterns of development changes of rnacrosomia wre analyzed statistically. Results The risk factors of macrosomia contain age and height of the pregnant women, weight before pregnancy, weight increasing during pregnancy, nutriture, physical activity, family history of obesity and father＇s weight. Macrosomia was weighter than normal birth weight infants in the 8 growth development monitoring time and was longer than normal birth weight infants from 3 to 30 months （ P 〈 0.05 ）. However, the length of maerosomia was not significantly different with that of control group when they were 36 months （ P 〉 0.05 ）. MDI and PDI in macrosomia group were （ 107.33 ± 7.29） and （ 104.71 ± 6.93） respectively. MDI and PDI of normal birth weight infants group were（ 112.58 ± 7.61 ） and （109.09 ± 7.14） respectively. The differences were statistically significant（ t =4.28,5.33;both P 〈 0.01 ）. Conclusion There were several risk factors for macrosomia such as environment and heredity. At the period of infants and young children, macrosomia were weighter than normal birth weight infants. The mental development and psyeho-moter development of maerosomia were behind normal birth weight infants.